pp. 297-298 in
Bioethics in Asia
Editors: Norio Fujiki and Darryl R. J. Macer, Ph.D.
Eubios Ethics Institute
Copyright 2000, Eubios Ethics Institute
All commercial rights reserved. This publication may be reproduced for limited educational or academic use, however please enquire with the author.
C4. Closing Address
Vice-President, ABA; Institute of Philosophy, Chinese Academy of Social Sciences, China
In this closing remark I would like to make two points: one, I think, is a vital issue, the other is urgent issue to Asian Bioethics or Bioethics in Asia.
The vital issue is how bioethics will flourish in Asian soil. Let me take an example in Chinese history. Since the beginning of Christian era, there had been many sects of Buddhism which came from India to disseminate Buddhism in China. However, all of them disappeared one by one until a sect called Zen emerged. Buddhists of Zen sect told Chinese that it is not important for anybody who wants to reach Nirvana to be a monk or nun in a temple or still to be a layman at home, to observe the rites and read the texts or not. Important is to do good to people. Everybody can be a Buddha, Buddha is in everybody's heart. In a Confucian context Chinese had already been taught that everybody can be a sage and sagehood is in everybody's heart. Before long, Zen became so popular in China that in a sense every Chinese was a Buddhist.
As many speakers at this Conference pointed out that there are cultural differences in many aspects of bioethics, such as principlism v. contextualism, how to understand or interpret a certain ethical principle (e.g. truth-telling), how to make a moral judgment on certain action (e.g. withdrawing treatment) and so on between West and Asia. If we just borrow everything in the West unchanged and plant it in Asian soil, I am afraid that bioethics would not grow up, an would not have its flowers and fruits. Of course, I believe that there are some ethical principles or rules which are universal in different cultures, but some are different, relative to culture, and the interpretation, understanding and priority of these universal principles or rules are different too.
Even in Asia there is cultural diversity. We have Confucianism, Buddhism, Hinduism, Islam, Judaism, Christianity and many aboriginal cultures. Even in a country there is cultural diversity too. Each culture has its unique conceptual framework, belief and value system. So when we talk about global ethics, don't forget the cultural diversity. If we recognize the cultural diversity, we have to admit that there are different moral communities in today's small world as well as in a country. To understand what happened in a culture other than one's is not an easy thing, especially in a rapidly developing state. As Chinese adage says, "to look flowers riding a horse" or "to eat the bread which has been chewed by others" and then to jump to a conclusion are inadequate. Cross-cultural criticism is necessary in this small world, but this should be based on dialogue and mutual understanding. I hope that some inter-cultural or multi-cultural approach to bioethics would develop, and from this approach some paradigms of bioethics would develop in Asia. Thus, Asian bioethicists will make our contribution to our common endeavour - developing bioethics in the world.
The second issue which is quite urgent in Asia is the implication of rapid development of market economy for health care. In China there is never ever a unified market in the history. After the government was determined to turn to the market, the market seems to be a blackhole around which everything is absorbed into it. The existing health care system which has been perplexed by skyrocketing medical costs and unjust distribution is in a crisis. Although many leading Chinese ethicists argued against the market entering into health care, and the government reaffirmed that health care is not a commodity, but a public good, a sort of welfare, but health institutions are more and more involved in the market.
The issues facing us include: Does the introduction of market mechanism into health care necessarily violate the principles of health care ethics? Does the relationship between physician and patient becoming the one as between provider and client violate the fiduciary relationship between them? etc. Many Chinese bioethicists including me are very confused about these issues. Market and medicine will be the next focus after the goals of medicine.
The issue of market and medicine is raised against a background in which there is a structural crisis of health care in many countries. My second point is also a suggestion that we should give adequate attention to bioethical issues at structural level as well as to those at individual level.
Of course, there are other important issues we should focus on, such as genetic engineering of plants, animals and humans, human genome project, human reproductive technology etc., but these bioethical issues in scientific frontier have been paid sufficient attention to, as showed at our two conferences in Kobe and Fukui, so I think it is unnecessary for me to say something about these again. Thank you.
Please send comments to
To contents page
To Japanese version
To Eubios book list
To Eubios Ethics Institute home page